Child Protection Transformation Project December 2011

Transcription

1 Child Protection Transformation Project December 2011

2 Child Protection Transformation Project Introduction The tragic death of Nubia Barahona and the abuse suffered by her and her brother Victor have become the catalyst driving a comprehensive review of the state of Florida s child protective response system. In March of 2011, an independent review panel critically examined the Barahona case and released its findings and recommendations identifying a number of systemic errors and omissions that occurred at various levels of the child protection system. Specifically, the report outlined the following key findings: Insufficient investigative practices and inadequate case management; Lack of integration of information sharing among child welfare professionals; Rapid turnover, inexperience, excess caseloads for child protection investigators; Unclear case integration; Unclear role of supervisors for case investigation and management; Insufficient attention to health care, mental health care, education support; and, Overall substandard quality of documentation by both case managers and investigators. Immediately upon receiving the report, the Department incorporated the recommendations into short term and long term action plans. The short term plan has resulted in numerous action steps taken by the Department, including, but not limited to, analyzing and updating all local law enforcement agreements, placing local community based care agency on a corrective action plan, entering into an agreement with the Agency for Health Care Administration to receive Medicaid claims data, deploying new requirements for Hotline management and operations, training over 1100 child protection investigators (CPIs), and requiring lead agencies to enhance accountability and expectations over case ownership. Despite these important short term steps, significant and sustainable improvement in child safety and well-being cannot be achieved without long term transformation of the entire child welfare system. Thus, the Department has embarked upon an From the time DCF is called upon to assist the child and family, to the time supports are no longer needed and the child and family reach a sustainable path, the entire child welfare system must act efficiently, collaboratively and in an integrated manner integrated Child Protection Transformation Project that will analyze and improve the many shortcomings in our investigative and service delivery business functions related to the flow and use of information across all the parties that impact the safety and well-being of a child. This will be a multi-year transformation project to advance the Hotline, protective investigators, and case management processes to world-class levels. The goal will be to improve the outcomes for child safety and child welfare. 1

3 Child Protection Service Delivery Model The business of delivering child protection services is complex, constantly evolving, and is accomplished primarily through the following delivery model. Families Florida Legislature DCF Abuse Hotline Investigators Case Managers Child Protection Partners Community Resources DCF is charged by law with protecting the safety and well-being of all children in Florida. DCF has a central abuse Hotline that takes calls from the public reporting cases of potential abuse or neglect. Once the Hotline determines that the call rises to the level of a report of abuse or neglect, a case is created in the statewide automated child welfare information system, known as the Florida Safe Families Network (FSFN). A criminal background check and search for prior alleged abuse or neglect reports is conducted at the Hotline and the matter is transferred to a local child protective investigator (CPI) who conducts an investigation. The CPIs within DCF perform child protective investigations in 61 counties statewide through its organizational structure, which includes regional directors, circuit community development administrators, operational program administrators and CPI supervisors. Sheriffs offices perform child protective investigations under grant agreements with DCF in six counties and by contract in one county. At the conclusion of the CPI investigation, which must be conducted within 60 days by law, the case is transitioned to a community based care (CBC) caseworker for ongoing case management, if it is necessary to help insure the child s continued safety and well-being. CBC caseworkers utilize FSFN for ongoing case management during the time services are offered to parents in the home, or when a child must be placed temporarily with relatives or in a licensed foster care home. Child Protection Transformation Project Vision The vision put forth is to transform the role of hotline, investigation and case management, so that each component of the system works as an integrated unit, equipped to gather better information, relay information faster, conduct more quality investigations, gather a more complete picture of the child and family, and offer a more effective engagement strategy to ensure the child and families safety and independence. Moreover, the CPIs, supervisors and leadership will be highly qualified and empowered with the range of expertise needed Empower investigator as and will build strong partnerships with a broad array of community partners. decision maker; Investigations will be conducted using the right core business practices that Create environment for allow for professional discernment and flexibility to deal with the unique stability and high challenges associated with each child and family, and the technology will be performance; aligned to properly support the work. CBCs and case managers will be held Transform data center into accountable for the child s safety and well-being and the information they command center; and receive will be accurate, timely and present a more complete picture of the Simplify, automate and child, family and needs. The end result will be to enhance child safety, wellbeing and integrate business process permanency. 2

4 Overall Message Florida s child protection professionals are dedicated workers putting in long hours to work passionately for the state s at-risk children. However, Florida s children continue to be maltreated sometimes even after DCF and our partners have intervened to provide services. The Child Protection Transformation Project retools our practice to better enable families the supports Case Processing to Child Safety Process to Outcome Management Entitlement to Independence necessary to provide children with a safe and nurturing environment. It will transform our culture from: Case Processing to Child Safety, Process to Outcome Management, and Entitlement to Independence. The change is sweeping and fundamental not a mere adjustment to cosmetics: From Individualized approach to case responsibilities by various professionals Limited access to information Discrete systems supporting Hotline counselors, CPIs and case managers One size fits all service In the office Complying with the required work steps Supervising from the desk To End-to-end collaboration/teaming with both internal and external partners and families served Easy access to all the information available about the Departments whole history with the family FSFN serves as the single electronic system supporting all aspects of child protection and service delivery Report-taking, investigations and case management tailored to the needs of the child and family In the field Focus on child and family outcomes Mentoring alongside the investigator While today Florida s child welfare fully complies with federal minimum standards, our goal is to provide world class child protective services. This will be achieved when Florida is recognized nationally and globally for having: Better child and family outcomes than other states: This will be achieved by creating a new culture of outcomes, new work practices, better information management, new ways of developing professionals, new services, different metrics, and new ways of working together. It is achieved when Florida can demonstrate qualitatively and quantitatively that we enable families to achieve better child safety, well-being and permanence; and Our Goal is to Provide World Class Child Protective Services Transformed efficiently: child protection programs around the world recognize the need to fundamentally rethink how they serve children and families. Florida will stop talking and start acting. In two short years, our child protection system will have achieved a pace and level of transformation that will be a model. 3

5 The Problem In partnership with our community-based care agencies and child protection professionals, DCF must improve along the following dimensions in order to deliver world class child protective services. 1. Downward spiral that is demonstrated in employee turnover and already eroding child safety. Over the past two years, CPI turnover has exploded, from 20% to 37%. Since it takes a full year to get a new CPI fully productive with an average tenure of only three years stabilizing the workforce is critical. In some circuits, average tenure is less than one year. The causes of this turnover include high workload, low pay and inadequate career path. High turnover has contributed to a rate of 55% of investigations as repeat investigations, or rework. DCF needs to immediately address the causes of turnover, or face a situation in which the Department is no longer able to enable effective child safety outcomes in every circuit. 2. Re-investigations and re-entry into child welfare system unusually high. Fifty-five percent of Investigations involve children the Department has investigated already within the past six months a tremendous rework burden and a potential sign that DCF may not be getting it right the first time. CPI Turnover 37% 55% Re-investigations 192 child deaths at hand of parents or caretakers in % of Hotline calls abandoned Approximately 70% of CPI time spent in the office Non-integrated systems Community outrage 3. High incidence of child deaths as a result of abuse committed by parents or caretakers. In 2009, 192 children died as a result of verified abuse committed by their parents or caregivers. Thirty-five percent of the families involved had prior referrals. Statisticians put a monetary value on life, often millions of dollars. DCF looks at lives differently. No child should die at the hands of his or her parent or caregiver. 4. Community outrage. The high profile case involving the tragic death of Nubia Barahona in early 2011, the resulting Miami-Dade County Grand Jury Report in July, and calls for dramatic improvement from the public at large all rightly demonstrate a community outrage and immediate need for change. 5. Non-integrated system architecture. The current Hotline environment is cobbled-together framework of the FSFN and a separate application developed as a workaround for FSFN shortcomings. The resulting system relies heavily on manual re-entry of information and results in information not presented in an easily readable format. Likewise, each of the CBCs has responded to FSFN s shortcomings by implementing standalone solutions. Ancillary automated systems for managing child protection cases is not supported by our federal partners who have financially supported FSFN and adds an unnecessary complexity to integrating database systems. 6. Inefficient tools and processes. The Hotline still takes 98% of reports by phone because the web reporting tool is unusable. The resulting call volume is so heavy that 8% of calls are abandoned. CPIs spend only 33% of their time in the field working with families because the 4

6 systems and processes require them to time driving back to the office in order to pick up and drop off paper files, and enter data into their desktop computer. We need to get them into the field, working directly with families for 50% or more of their time. Community based care case managers face a similar problem. 7. Information not available in a usable manner across the entire child protection process. From reporter observations that lead to a Hotline call to case closure, stakeholders who are involved in serving a child and the family need to have access to all of the information required to enable the family. The FSFN system does not provide easy, structured access to the situation of the whole family in a manner that supports effective investigations and case management. 8. Limited use of other agency information. Today, investigators and case managers do not have the proper tools and supports to maximize on their use of information on a family or child that they are authorized to access. DCF needs to make proper use of outside information from other state agencies. Without computer assistance to package information for ease of use, providing access limits the ability to make the best use of the information available. 9. DCF and partner organizations work independently, rather than partnering. Transferring a case from investigations to case management can create a threat to child safety if done poorly. This needs to build on best practice relationships and a new form of accountability and trust. 10. Compliance-based practice model. Today, Hotline counselors, CPIs and case managers are oriented by supervisory styles and metrics to complete tasks rather than enable families to provide child safety. DCF and its partners need to collaborate in a practice model that is based on safety and teamwork, and focused on safe outcomes. This is the leading edge of child welfare internationally. DCF has the opportunity to build on the experience of a few states to build world class child safety. Solutions The Child Protection Transformation Project includes many individual solutions that, taken together, will create world class child protection. The solutions fall into four categories: people, process, technology, and legislation. People Process/Practice Technology Legislation *Recruitment *Staffing Pool *Supervisors *Pay Rates *Training and Professional Development *Family Engagement *New Partnering Practices *Metrics *Enforcement of Accountability *Improved Case Transfer Process *Data Integration *Quality Software *Information Driven *Business Functions *Dashboard and Management Reporting *Document Management *Mobile Technologies *Assessment at Hotline *Close Case Early if Appropriate *Require Immediate Consultation with Other Professionals *Expand Investigation *Establish Single Electronic Record 5

7 1. People Develop a career step-ladder - Create levels of expertise within the child protective investigative process that enables specializing and gaining certification status within the profession. Establish a process - Immediately hire temporary CPI staff who can begin the training process for easy transition to a certified investigator to reduce the vacancy rate and mitigate present unmanageable caseloads. Create a field staff supervisory model Adopt the law enforcement model of supervision that focuses on mentoring and oversight of CPI work in the field with families. 2. Process/Practice Family centered practice built on a safety model The focus for transforming investigations and delivery services through the engagement of families to best determine safety and risk of a child will position Florida as a world class child protection system: From event-based risk assessment to family-based safety assessment From individual activity to team-based investigations From compliance with prescribed steps to focus on child and family safety outcomes New partnering agreements and practices Building on statewide best practices, we will reform formal agreements with law enforcement and other community partners and shift the role of an investigator or case manager from sole practitioner to team coordinator. Metrics To improve child safety, we will transition from a compliance-driven performance monitoring system to a new outcome-focused set of metrics to achieve new standards in accountability of all professionals and families served. Enforcement of case manager accountability Existing contract requirements with our communitybased partners will be enforced more carefully, through the aid of case-level compliance tracking. The focus shifts to outcomes and increased motivation to high levels of performance. Improving case transfer processes from Hotline intake through investigations to service delivery The creation of assessment capacity through web-enabled and caller reporting at the Hotline will standardize and improve decision-making at all phases of case processing. In each of these handoffs, DCF will implement continuous improvement to find the key sources of poor handoff, work together to identify the underlying causes, implement improvements, and measure improvement. 3. Technology New user interface with point and click, pull and drag functionality rather than data entry A new user interface within FSFN will create a new method for implementing user functionality, based on the flexible tools of the Internet. This will allow a series of projects to start with Hotline screens 6

8 which provide a complete view into the family and the child s history with DCF. Hotline screens will be built will an eye toward CPI and case management needs. Once funding is available for CPI and case management screens, community stakeholder documents will be made electronically available to increase flow of information from all child protection professionals involved in a case to enhance team knowledge of critical information about a child and a family for effective team-decision purposes. It will also reduce the use of paper. Data integration - Changes to FSFN will be made to support data integration and information sharing with other state and local agencies such as Education, Early Learning Coalitions, the Agency for Health Care Administration, Juvenile Justice, Guardian Ad Litem, and the courts system. Quality software The Hotline will upgrade its existing telephone software that is funded through current operating budget. The upgrade is necessary in order to fundamentally change the manner by which Hotline counselor performance is managed. Counselors will shift from process point to technology; from being graded on how quickly they can conclude an interview to how effectively they can assess information to make a determination about whether a protective investigation should be commenced. Information driven business functions (e.g. alerts) DCF will create new data sharing relationships with key data sources such as the Department of Education and the various judicial and law enforcement agencies. The new user screens will allow CPIs and case managers the new opportunity drill into data and learn case specific information about children on their caseload. In addition, DCF will build data analysis tools that help with decision support. These alerts will help CPIs and case managers to identify the information that is most relevant and potentially elevate risk and safety factor that may be developing with a child. Dashboard and management reporting DCF will develop a dashboard at two levels. The first is for CPIs and case managers. It presents current case and performance status through the new user screens described above. The second is a new tool providing each level of management a window into practice and operating performance. Document management Today, CPIs and case managers produce, file and archive at least 80 pages of documents per case. The solution will allow most documents to be created and signed electronically. Mobile technologies CPIs and case managers need the capability to use any variety of devices to access FSFN, outside data, performance reporting, case status and the other important aspect of managing cases and their workday. Devices could be laptops, tablets, tablet computers, or even smart phones. In addition, the project will implement a remote office including printer, remote access connection, back-up batteries everything a CPI needs to be productive without many trips back to the office. 7

9 4. Legislation Safety assessment instrument Changes to Chapter 39 will establish the use of a standardized safety assessment instrument that begins at the Hotline and used throughout the life cycle of a case. Discontinue Investigations Amendatory language enables CPIs to discontinue investigations when a report is found to be false or the initial safety assessment is complete. Expand Investigation CPI has the digression to expand an investigation if warranted by the situation they find. This works in conjunction with the right to reduce steps in other cases allowing CPI to be more effective across all cases. Electronic Record Proposed language clarifies that FSFN is the single electronic record to maintain information on a child and family to eliminate development of duplicate systems to maintain similar data. Investment Florida s legislative process plays a critical role in transforming child protective investigations and enhancing safety, well being and permanence for children by taking three steps. Changes to Florida Law First, the transformation project requires changes to Florida Statutes Chapter 39, the law that controls child protection in our state. Changes to Chapter 39 will allow child protection investigators and partners to focus their work on building safety for children who truly need intervention services. A child protection bill, sponsored by Senator Rhonda Storms and Representative Jose Felix Diaz, has been filed to enact revisions that will streamline the investigative process. Investment in Enhancing Safety of Children Second, the project requires a financial investment that the legislature has endorsed through the appropriation of $5, during the 2011 session to deploy essential upgrades to the Hotline function. The department is procuring a systems integrator to significantly improve web entry for reporting child abuse to eliminate abandoned call rates and provide more complete, accurate family information to field staff. Governor Rick Scott has included in his budget proposal the Department s request for a one-time investment of $20 million in fiscal year to transform field work practice by equipping CPI s with mobile technology to increase efficiencies and reduce gaps in connecting families to services Support Redesign of Human Resource Requirements Third, the project requires essential changes to the recruitment, certification and professional development of child protection staff. Governor Rick Scott has included $9.8 million in his budget to enable the CPI workforce to hire investigators-in-training who will enable the creation of a tiered workforce to ultimately attract and retain highly qualified and committed child protection professionals. An additional $20 million will be requested in FY to further address to continue the redesign. Creating levels of expertise in child protection and adopting the law enforcement model of field supervision will transform the protection of children and create a way of work that focuses on outcomes that lead to independence of families. 8

10 Fast Impact World class is never built in a day. Building the best child protective services in the world will take years. However, part of DCF s success will be achieving major change quickly. In doing this, it will World class is never built in a day, but define an effective change process, showing the way for other Florida agencies, and for other child protection building momentum, sustainable change, and demonstrating positive agencies globally. This will be based on building outcomes through measurement must momentum quickly, achieving sustainable change, and start today. demonstrating positive outcomes through measurement: FY 2012 FY 2013 FY 2014 and Beyond Establishing momentum Developing measureable results Stakeholder improvements Better quality reporting capabilities through web enhancements at the Hotline Hotline improves accuracy of intake process through standardization of assessment of calls to Hotline Hotline creates new presentation of case history information for CPI ability to easily obtain information on family and child Child Welfare Program Office implements business function re-design in each region to create baseline for transforming current practice with existing resources Performance incentives for CBCs provide a new system of rewards (penalties) based on outcomes CBCs achieve in their casework. The focus shifts to outcomes and increased motivation to high levels of performance Technical solutions fully implemented in Hotline, on-time and on-budget Increase web reporting from 1% to 10% Reduce time to complete a phone report from 27 to 24 minutes, and to 18 minutes for a web report Reduce abandoned calls from 8% to near zero New Hotline screens launched that allow Hotline counselors to access more complete information about families and history to improve completeness of package to CPI Investigations as a percent of reports reduced 10% CPI achieves 10% reduction in turnover by (1) adding staffing pool that takes some heat off of caseload (2) increasing wages CPI introduces the best national safety framework and practice model CPI launches tablet computers and improves the usage through rigorous feedback and iterative improvement Business function re-design of new CPI practice evaluated positively in interviews with stakeholders Statewide roll-out begins for standardized new practice model, staffing changes and technology People, process and technology solutions supporting CPIs and case managers fully implemented statewide Quality improvement system in place for Hotline, CPI and case management statewide First measurable outcome results Key federal compliance metrics improve Repeat investigations drop by 15% compared to 2012 Repeat maltreatment rates drop by 2% compared to 2012 QSR evaluates of CPI and case management improved significantly in every category of performance and family status In school and at-grade levels improved Compliance with safety plan improved 9

11 Aggressive, Balanced Benefits These changes will produce world class child protective services by achieving measurable improvement: Today Tomorrow Financial 37% Child Protection Investigator turnover 20% Child Protection Investigator turnover 2% Abuse Hotline counselor turnover 20% Abuse Hotline counselor turnover 2% Supervisor turnover (Hotline and 10% Supervisor turnover (Hotline and Investigator Investigator combined) combined) Process/Practice 8% Hotline abandonment rate for calls not Near zero abandonment rate answered 27 minutes per report call 24 minutes per report call and 18 minutes per web report handling 1% web reporting capacity 10% web reporting utility 65% investigations that result from reports to 55% investigations for reports through refined Hotline assessment All investigations require full investigation 25% of investigations lead to no finding and are terminated early 10% of investigations include steps beyond the minimum adding to child safety 33% CPI time in the field engaged with 50% CPI time in the field engaged with families and families assessing children 20% CPI Supervisor time in the field 80% Supervisor time in the field to coach and mentor CPI Average CPI case level of 1:20 Average CPI case ratio of 1:12 Learning No formal tracking of professional Professional development is part of every employees development Professional development - Hotline and CPI personnel spend little time learning No measurement of educational impact Child & Family Outcomes 55% investigations result in repeat calls to Hotline with new allegations No quality review system for monitoring individual case practices with CBC s performance expectation Experienced Hotline and CPIs invest 10% of time in professional development through real-time learning and other opportunities All training is assessed for application to work, and impact on work performance (levels 3 & 4 of Kirkpatrick s schema) 25% repeat investigations through family engagement practices Quality reviews conducted on investigations in every circuit focusing on CBC outcomes for services Child Protection Transformation Project Review The Child Protection Transformation Advisory Board was established by Secretary Wilkins in June 2011 to provide independent, expert observation and monitoring of the goals of the project. Representation includes, the legislature, judicial branch, sheriff offices, CBC lead agencies, child advocates, medical authorities, the philanthropic community, attorneys, sister agency experts and a foster/adoptive parent. Comprised of a broad array of authorities on children s issues, they convene quarterly to review the project and offer consultation on progress made. Information about the Board, their activities and upcoming meetings can be found on the DCF website. 10